I look after vulnerable people as a Security Warden supervising Homeless Hostels at night. We sometimes have persons prone to epileptic seizure. My First Aid course just told me to clear the area around them, then speak to them reassuringly.

I was told that if they fit for longer than 5 mins, call an ambulance or if, after the fit ceases, they do not recover within another 5 mins [10 mins total]; again, call an ambulance.

Is this all there is to know ? Is there any more I can do for them ?

[Addition After Posting: I have since spoken to an epilepsy sufferer and she has told me that during seizure her worst problem is a sense that the convulsion will never end, that she is stuck in it and cannot get out. She describes fighting against it to try and control it. She told me all she needs is for someone to touch her lightly on the shoulders, to look into her eyes and just to speak her name and reassure her that it will all soon be over. I know that in some cases seizures can be quite a physical thing but I am not aware they are ever 'violent' as such, so what she requests sounds, to me, quite reasonable.]

  • Regarding your addition: That’s encouraging to hear. You already addressed this in your post with “talk to them reassuringly”, but I’ll edit it into my answer. Touching lightly on the shoulder should not cause any problems (use common sense there, if she’s having a violent fit, maybe not), and talking and taking care of the psychological aspects is an often underrated aspect - hence my encouragement for privacy.
    – Narusan
    Oct 11 '17 at 14:29
  • @Narusan-in-coma I once helped out at the Epilepsy Centre in the UK and some of the severe sufferers had very considerable disability from repeated convulsions. Some of them used to wear a rubber ring around their head to protect them when they fell during seizure. One young man I helped with had no front teeth, having lost them in a fall fit. It can be a very serious condition indeed.
    – Nigel J
    Oct 11 '17 at 14:34
  • From what I’ve heard, the first few occurrences are the most shocking. I can imagine - losing control over your muscles must be a horrible feeling. Once one gets accustomed to it, the psychological aspects are less severe, and some form of protection (rubber ring, having good friends near you who know of your condition) can be of assistance. So can having a well-trained security warden.
    – Narusan
    Oct 11 '17 at 14:45

There is not more you can do

The Red Cross strongly recommends to not restrain them but let them go through their seizure, otherwise you will cause injury to them, and notes nothing more that can be done.

The CDC has the same information on their website.

Call an ambulance if the seizure lasts longer than 5 minutes, get a few bystanders to make sure the ambulance knows where to get, ensure the patient has at least a little bit of privacy (it helps to send multiple people running for defibrillators just in case, if there’s a large crowd), wait, talk to the patient and reassure them that someone is there for them, and monitor breathing without touching or restraining the patient.

What paramedics are able to do

Paramedics, Emergency Doctors and other first responders (it is depending on legislation and institution who’s allowed to do what) will inject Valium or benzodiazepines en route to the hospital.

Benzodiazepines can cause some people to stop breathing, breathe too shallowly or can cause cardiac complications.
(Cited from the study)

This is (apart from the difficulty with injections and legislation) why regular people are not allowed to administer such drugs.

Furthermore, it is important for the EMT’s to secure airways and ensure that the patient’s blood is saturated with oxygen enough after a severe case of epilepsy: Regardless whether they administered medication, some patients will stop breathing. This is also one reason why you have to call the ambulance after or during a severe case of epilepsy.

If the patient stops breathing

If the patient should stop breathing before the ambulance arrives, then there is something you can do. Start CPR, look for public defibrillators and do what your first aid training has taught you.

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